Roberts Hospital patient

August 10, 2010

My father worked in Roberts Hospital but was also a patient there on at least two occassions.  On November 9, 1942 he was admitted with fairly acute forms of pellagra, a vitamin deficiency disease, and tinea cruris, a skin fungal disease otherwise known in Singapore as ‘Dhobi Itch.’   He would remain in hospital for almost three months before being discharged on February 5, 1943.  During this time he kept an almost daily record of his condition, diet and medications.  Many of the entries are too personal to be quoted here but I have selected a few from the weeks leading up to and following his discharge.  A more extensive account of his Christmas Day, 1942 appears in an earlier post.

10th January

Acriflavine painted on – not on gauze.  There is no sign of Tinea or Diphtheria. Pulse remains around 64.

19th January

Marmite replaced by 1/2 pint rice polishings.  Can now walk several hundred yards with no effect on heart.

February 5

Released from hospital.  Still rather weak on legs but otherwise quite OK.  Head swims after standing for half an hour or so.

13th February

1 week’s special diet.  Weight 9st. 8lbs. without boots. Feeling well except for rheumatic or sprained feeling in ankle joints & in neck.  The ankle feels as though it would give way when bearing weight of body. Cannot walk without stooping.

6th March

1 week’s light duty.  Off special diets. Weight 10 st. 0lbs.

Book D, pp. 13-14

Health and Food

May 2, 2010

This note is from November 1942 or thereabouts, though whether it was written before or after the onset of pellagra and tinea cruris is not clear.  Either way,the diseases were very much on his mind as he refers to them several times on adjacent pages.

I’m intrigued by the use of the past tense.  It is consistent with the detached way in which he often wrote about things; from an early age he had been well trained in the language of the scientific report.  On the other hand, I can’t help wondering whether it also reflected a different kind of detachment; one that perhaps helped to protect him from the deprivations and horrors of daily life.

Health & Food

That these two factors are closely related was abundantly shown in the POW camp where both men & dogs were living on impoverished rations,  The dogs ate mainly rice.  Their meat diet consisted only of bones which had been boiled to such an extent as to devoid them of all nutrients. The dogs, although remaining apparently healthy, developed mange.  This was demonstrated even more so by a bitch which developed mange very soon after littering.However, they did not appear to suffer from any of the deficiency diseases.

Men were also existing on a rice diet augmented with vegetables, meat, fish & fruit.  But the scarcity of the B group of vitamins was largely responsible for many deficiency diseases such as the various manifestations of beri beri & pellagra.  Skin diseases also increased & wounds took much longer than usual to heal.

Book B, 99

Marmite

May 1, 2010


I wouldn’t say that I’m particularly fond of Marmite, though I can’t help thinking that it’s a poor sort of pantry without it.  I quite enjoy it on toast even if I do wince a little every now and then.

My father swore by the stuff. True, I never saw him actually eat any but his brand loyalty was deep and unwavering. As indeed it should have been for it was a central part of his treatment for pellagra (he was also suffering from tinea cruris) at Roberts Hospital between November 1942 and February 1943.

Pellagra is a deficiency disease and as a yeast extract Marmite is very rich in B vitamins. Dissolved in half a pint of warm water it was part of his daily regimen.  Well, that and half an ounce of rice polishings.

“We wouldn’t have survived without this,” he used to say brandishing the familiar little jar. “Beautiful.”

Diphtheria precautions

February 26, 2010

The following guidelines at Roberts Hospital speak for themselves but also to the conditions.  Cigarette stubs were a precious commodity.  I’m not sure who would have been smoking cigars.

Precautions to be taken against Diphtheria epidemic

(1) Cancel all entertainments & lectures
(2) Beds to be spaced so as to give sufficient headroom (sleep head to foot if necessary)
(3) The picking up of cigarette & cigar buts for reuse is prohibited
(4) All sore throats, however trivial, are to be reported
(5) Patients to be isolated
(6) Staff to be isolated from other personnel
(7) Staff to wear nose & mouth guards (made of gauze) when working in wards
(8) Patients to wear nose & mouth guards when being moved in vicinity of non infected persons
(9) All drinking containers to be sterilized in boiling water

Book B, p.56

Reading as escapism?

January 2, 2010

There were books at Changi; thousands of them.  One source was Singapore library the contents of which had been trucked to the camp after the Japanese had been persuaded that plenty of reading would divert the prisoners’ attention from thoughts of escape.  This must have led to a good deal of bemusement about whether reading was or was not to be encouraged as an escapist activity; a delightful linguistic conundrum that was presubably lost on the Japanese.

Christmas Day 1942 found my father in Roberts Hospital enjoying Ethel Boileu’s Arches of the Years.  But on the whole his taste was in non-fiction.  Even then it was highly eclectic including (at least in the early months of captivity) textbooks on anatomy and physiology, British government circulars on food preservation and various works on world affairs.

Sometimes he simply made lists of books to be tracked down in the future, presumably from citations he ran across in his current reading.  For example, pages 488 and 489 of his first Changi notebook include references to Frowhawk’s A Natural History of Butterflies, Muir’s Mother India, Clegg’s War-time Health and Democracy, Greenwood’s Love on the Dole, Imms’ Recent Advances in Entomology and Cox’s The Chemical Analysis of Foods, among others.

Quite often he made elaborate notes on what he read, as in the illustrated page on the Public Health (Imported Food) Regulations of 1937.  Sometimes he wrote out lengthy passages verbatim. In such instances he was no doubt trying to capture as much detail as he could for future reference.  But it was a laborious method he had also adopted in his pre-war notebooks.  No doubt he found refuge in the elaborate note taking; at the very least it would have filled up a considerable amount of time.

A Changi Christmas

December 23, 2009

My father was admitted to Roberts Hospital with pellagra on November 9, 1942 and not discharged until February 5, 1943.  He kept daily notes on his condition and treatment but the only time he permitted himself any observations of the world about him was on Christmas Day.  The following notes are reproduced more or less in full though a few unreadable words and passages have been omitted.  He crams a lot into them.  The one comment I’d add now is that they include the only reference I’ve been able to find to the Alexandra Hospital incident  in any of the notebooks other than the three eyewitness accounts that I suspect were written down near to the end of his captivity.

Xmas 1942

Roberts Hospital, a patient with Pellagra, the B1 vitamin deficiency disease – indulging in too much polished rice to the exclusion of cereals & other good things.  Complicated with Tinea Cruris & tertiary infection of Diphtheria & other odds & ends.

Passed a miserable night, having been tortured by the relays of bed bugs which have their homes in the crevices of the bed & mattress & which I am at present quite powerless to eradicate.  However, managed to get off to sleep during the early morning & slept soundly until about 8.30am when I was awakened by the sound of tea mugs being deposited on the tray. A lovely cup of hot milked & sweetened tea followed (the first “official” one for about 6 months)

Later had breakfast of cornflour porridge (sweetened) followed by Tomato (complete with skins & pips) & a thin slice of tongue (unheard of!).  Also 2 slices of rice bread (4” x 2”) the one with army butter (margarine?) the other with pineapple jam (v. good).  Somebody heard to say “You lucky patients”

At this time Ack Ack Williams Pte. popped in to wish a Merry (if possible) Xmas.  I reiterated that I would not add “many of em.”

Contemplating partaking of a noxious Kum Lan cigarette made of cherry leaves  & costing 15c in the Canteen (a rise of some 500%!) –  product of Godfrey Philips India Ltd. Victory V Cigarettes  (which incredibly depicts a V over the rising sun).

At 9.30 a service started over in the next ward accompanied by a rather unsteady accordion. Starts of with “Come Ye, Come Ye to Bethlehem” (rather impossible in the circumstances).  Preaches something about Peace on earth & goodwill towards men (somewhat ironical) & continues with Lord’s Prayer “Give us this day our daily bread”(!)

Toffees (very sticky but very acceptable) distributed to each man.   Another 2 followed out of the blue given by Red X officer who wished me Merry Xmas.   A second pkt of Victory V cigarettes & biscuits followed.  Scoffed many biscuits & sweets.

Bill Sayer came in later in morning & said what an awful breakfast he had.  Couldn’t eat it.  Mabela (?) was full of maggots, biscuits were made of rice & like leather.  Coco  had no sugar & little milk.  Lent me a novel “The Arches of the Years” by Ethel Boileau (Hutchinson & Co London) which incidentally originally belonged to one Carlyle Morier  a sanitary inspector not residing at the POW camp Changi.

Bill’s visit interrupted by Company Officer & RSM Painter who came to wish me a Merry Christmas, a quick recovery & gave a pkt of 3 Castle’s cigarettes & smoked one each.

“Get ready for the first course”– pea soup, clear (& good) followed by the 2nd & 3rd courses.  Tiffin consisted of a slice of pork (tender & thin & easily cut with the spoon) sweet potato & local pumpkin set in thick brown gravy.  Somebody protested that the latter had been made with burnt rice but the server indignantly replied that he could assure him it was not & added that if this f—–g sauce hasn’t got some rum in it I’ve picked a (unreadable).”  This sauce was poured over a goodly block of excellent Christmas pudding.

After some reading of Bill’s book Williams came in said tiffin was lousy.  Consisted of a cup of bully beef 1 ¼ inch square, 2 thin slices from a small beetroot, & split pea soup & no sweet.  His temper was cooled down however by a piece of Christmas pudding given him legally for his ward, a couple of Cheroots for his Wardmaster.  I fed him on toffees & a cigarette.  Left later to attend a concert in his ward.  Talked of field kitchens, roast duck, boiled rice biscuits et. al.

Continued to read ‘The Arches of the Years” with breaks for toffees, biscuits & cigarettes throughout the afternoon.

Tea consisted of milk sweetened tea but with no bread.  Then there was also no Marmite or indeed treatment of any kind (the MO looked in about dinner time).

Dinner consisted of only one dixie, Cornish pastie (m & v in rice pastie) rice, a few long beans & a slice of Yorkshire pudding.  Also a mug of milk sweetened tea.  Took the rice to keep me in trim.

Read Bill’s book till Bill Batty came in.  Brought 2 tangerines (I asked for a couple of mangos for Christmas the last time he visited with no hope of seeing them.  Even now it is doubtful of their origin).  Also a promised book “Days of Our Years” by Pierre Van Paassen (?) (Angus & Robertson Ltd, London, 1940) also some peanuts to eat while we chatted.  Chatted of old times in Malaya, the war & the Alexandra Hospital tragedy & the loss of Arthur Collins & his pal Sidall who I relieved at Tekong.  Later conversation interrupted by Farrant coming in for his daily evening chat.  Conversation soon changed to watches, one Batty gave to F with hand missing.  Belonged to Bill Brandt who capped the lot by also appearing on the scene.  Soon left on pretext of Batty to go to the boreholes.  Farrant remained to eat part of tangerine, peanuts & a cigarette.  Talked of news – advance in Burma, 100 mile road with 50 bridges cutting off water. Later turned to architecture & chances of getting out of here.

After cup of coco made bed!  Later Ack Ack Williams came along & started to tell some jokes but was soon interrupted by McNeil (orderly) who came along with the red hot news that the Russians were moving south along the Polish frontier.  Lights out went soon after.

Book D, 17-18



That my father devoted nineteen pages to the treatment of dysentery within a couple of weeks of arriving at Changi gives some indication of the incidence of the disease and the challenge facing the improvised hospital.  The pages illustrated below indicates the treatment for “very weak” patients as including colonic lavage, Kaolin, glucose saline, Virol and arrowroot or custard along with Bovril which was obviously still available.
Still, providing treatment in such conditions was only part of the challenge.  Flies were a ubiquious problem, for example, and patients were expected to do their part in eradicating or at least reducing them.

The general practice at Roberts during these early weeks and months included the following:

Precautions against the spread of the disease may be summarized by (1) the elimination of flies (2) personal hygiene.  In more detail these precautions include:

(1) The killing of all flies in the ward and sanitary annex.  This is done chiefly by swatting: many of the patients can help in this respect.  Fly papers, both hanging & placed on the ground, are also used but these are more of a nuisance than anything else.  Swatting should be carried out all day on & around the beds. The fly papers are more or less permanent & when full are replaced by new ones.

(2) The protection of all food from flies. All feeding jars, mugs, cups and utensils are covered after use with squares of gauze.  Bulk foods are stored in fly-proof cupboards, preferably with well ventilated gauze front & for sides.

(3) The protection of all excreta from flies.  All bedpans & urine jars, vomit bowls, spittoons etc. must be emptied immediately after use & rinsed out with cresol solution.

Book A, 56-57